The comparative validity of a brief diet screening tool for adults: The Fruit And Vegetable VAriety index (FAVVA)

Lee Ashton; Rebecca Williams; Lisa Wood; Tracy Schumacher; Tracy Burrows; Megan Rollo; Kristine Pezdirc; Robin Callister; Clare E Collins

doi:10.1016/j.clnesp.2018.10.007

The comparative validity of a brief diet screening tool for adults: The Fruit And Vegetable VAriety index (FAVVA)

Clin Nutr ESPEN. 2019 Feb:29:189-197. doi: 10.1016/j.clnesp.2018.10.007. Epub 2018 Nov 2.

Authors

Lee Ashton¹, Rebecca Williams², Lisa Wood³, Tracy Schumacher⁴, Tracy Burrows⁵, Megan Rollo⁶, Kristine Pezdirc⁷, Robin Callister⁸, Clare E Collins⁹

Affiliations

¹ School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia. Electronic address: lee.ashton@newcastle.edu.au.
² School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia. Electronic address: rebecca.williams@newcastle.edu.au.
³ School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Electronic address: lisa.wood@newcastle.edu.au.
⁴ Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia; School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Gomeroi Gaaynggal Centre, University of Newcastle, Department of Rural Health, Tamworth, Australia. Electronic address: tracy.schumacher@newcastle.edu.au.
⁵ School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia. Electronic address: tracy.burrows@newcastle.edu.au.
⁶ School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia. Electronic address: megan.rollo@newcastle.edu.au.
⁷ School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia. Electronic address: kristine.pezdirc@newcastle.edu.au.
⁸ Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia; School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. Electronic address: robin.callister@newcastle.edu.au.
⁹ School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia. Electronic address: clare.collins@newcastle.edu.au.

PMID: 30661686
DOI: 10.1016/j.clnesp.2018.10.007

Abstract

Background & aims: A brief assessment tool on frequency and variety of fruit and vegetable intake could provide a cost-effective and sustainable approach to improving diet. The primary aim was to evaluate the comparative validity of a brief index of Fruit And Vegetable VAriety (FAVVA) relative to food and nutrient intakes derived from a comprehensive food frequency questionnaire (FFQ). The secondary aim was to evaluate the FAVVA index in relation to fasting plasma carotenoid concentrations.

Methods: Dietary intakes and fasting plasma carotenoid concentrations of 99 overweight and obese adults (49.5% female; 44.6 ± 9.9 years) were assessed at baseline and 3-months. Food and nutrient intakes were assessed using the Australian Eating Survey (AES) FFQ. The FAVVA index was derived from a sub-set of 35 AES questions related to fruit and vegetable intake frequency and variety. Associations were assessed using Spearman's correlation coefficients and linear regression analysis, and agreement using weighted kappa (K_w).

Results: Total FAVVA score demonstrated moderate to strong, significant (all p < 0.01) correlations with total daily intakes of vegetables (r = 0.75), vitamin C (r = 0.71), fruit (r = 0.66), vitamin A (r = 0.49), fibre (r = 0.49), potassium (r = 0.46), magnesium (r = 0.39), iron (r = 0.26), riboflavin (r = 0.24), calcium (r = 0.23), zinc (r = 0.20) and niacin equivalent (r = 0.20). These associations remained significant in the adjusted regression analyses and agreement testing. Total FAVVA was significantly correlated with plasma carotenoid concentrations (μg/dL) of α-carotene (r = 0.22, p < 0.01), β-carotene (r = 0.26, p < 0.001), β-cryptoxanthin (r = 0.22, p < 0.01) and total carotenoids (r = 0.18, p < 0.05). The associations with α-carotene (β = 0.09, p < 0.001), β-carotene (β = 0.42, p < 0.05) and total plasma carotenoids (β = 0.85, p < 0.05) remained significant in the adjusted regression analyses and for agreement testing.

Conclusions: FAVVA is suitable as a brief tool to rank frequency and variety of fruit and vegetable intake.

Keywords: Dietary methods; Food frequency questionnaire; Fruit; Validation; Vegetables.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Australia
Carotenoids / blood
Diet*
Energy Intake
Female
Fruit*
Humans
Male
Mass Screening*
Middle Aged
Obesity
Overweight
Surveys and Questionnaires
Vegetables*
Vitamins
Young Adult

Substances

Vitamins
Carotenoids